Welcome to the Northeast edition of Outbreak Outlook! It is only available to paid subscribers. If you wish to become a paid subscriber and access region-specific information, please click the Subscribe now button below. Thanks for reading! -Caitlin Respiratory DiseasesInfluenzaI am happy to report that the Northeast saw substantial improvement in influenza activity this week. Every state in the region saw declines in emergency department visits, many of them quite steep. New Hampshire reported the highest ED visits at 6.2%, down from 8.4% the week prior. Massachusetts and New Jersey followed at ED visits of 5.3% and 5.1% respectively, both down sharply from the prior week (8.7% and 8.4%). None of these states reported outpatient ILI this week. New York saw a dramatic drop in outpatient ILI, falling from 10.9% to 6.6%, the highest in the region. Interestingly, ED visits there are now among the lowest at 3.2% (down a lot from 6.5%). New York City also reported hefty declines in ED visits, now at 2.5%. This aligns with were the city was around Thanksgiving time. Connecticut and Rhode Island both improved too, with ED visits falling to 4.4% and 4.1% respectively. Connecticut dropped from 8.5%, one of the steepest declines in the region. Neither state reports outpatient ILI. Pennsylvania and Maine both came in at 4.1% for ED visits, each down from the prior week. Both states also report outpatient ILI: Pennsylvania at 4.0% (down from 5.1%) and Maine at 4.9% (down from 7.6%). Northeast: ED visits for influenza (%)
% of visits to the emergency department that are for influenza
 Vermont had the lowest ED visits in the region at 3.3%, down from 6.4%. No outpatient ILI data is available. The Center for Forecasting and Outbreak Analytics is also estimating robust declines in all states in the region. I think we may be past peak! COVID-19Covid-19 activity is moderate, but trends are mixed, depending on which metric you look at. ED visits for Covid-19 are declining, but wastewater tells a more complicated story. Maine had the highest ED visits in the region at 1.3%, down from 1.8%. However, wastewater there to very high levels. Pennsylvania is in a similar spot, with ED visits at 1.2% (down from 1.4%) but wastewater rising into the very high category. New Hampshire reported 1.2% ED visits (down from 1.5%) with high wastewater that increased slightly. Massachusetts, Vermont, and Connecticut all have high wastewater levels, though all three saw concentrations decline this week. ED visits in those states ranged from 1.0% to 1.1%, all improving. Northeast: Covid-19 wastewater concentration
Wastewater concentration of SARS-CoV-2
 Rhode Island saw a sharp drop in wastewater, now at low levels, with ED visits holding steady at 1.2%. New Jersey and New York are in the best shape in the region. New Jersey has low wastewater (flat at 3.0) and ED visits at 0.7%. New York saw wastewater plummet from to very low levels, with ED visits at 0.6%. In New York City, ED visits held flat at a comfortably low 0.3%. The divergence between declining ED visits and rising wastewater in Maine and Pennsylvania suggests that some states in the region are in a plateau, but the overall picture in the Northeast is one of moderate activity and improvement. Northeast: ED visits for Covid-19 (%)
% of visits to the emergency department that are for Covid-19
 RSVRSV continued to decline across the Northeast, with every state below 0.6% of ED visits. New Jersey was highest at 0.5%, down from 0.7%. Rhode Island saw a notable drop from 0.7% to 0.4%. Hospitalization data is limited, but New York saw a slight increase while Connecticut declined. Northeast: ED visits for RSV (%)
% of visits to the emergency department that are for RSV
 Stomach BugsNorovirus is moderate in the Northeast, with test positivity around 9.4%. This is higher than the summertime lows of below 5%, but well below the 20%+ peaks we sometimes see. Noro season lasts into springtime, so I expect activity to remain elevated in the weeks ahead. Food recallsThe following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items: New:
Previously Reported:
In other news
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THE WORLD READS WHITE PLAINS CITIZENETREPORTER — 8,324,077 VISITS IN ONE YEAR
2,905,611 VISITORS VISIT 8,324,077 TIMES 3 TIMES EVERY DAY IN ONE YEAR. HIGHEST ACTIVITY IN WPCNR HISTORY.White PlainsCitizeNetReporter lifted its worldwide visits from unique visitors to wpcnr.com to 8,324,077,a 1,306,419 increase in visits in one year from 7,017,658 visits to the site last year which covers White Plains and Westchester County. The 8,324,077 visits were made by 2,005,611 unique visitors who visited wpcnr an average of 3 visits a day. ON JULY 20- -2026 visitors have accessed wpcnr and made 3,072 visits an average of 1.6 visits. In the last week 33,495 individual vistors made 54,458 visits, averaging 1.6 visits. In the last month, 152,940 visitors recorded 229,338 visits (1.5 visits)
